Heavy drinking and prostate health don't mix

July 13, 2009

While current research regarding the relationship between alcohol consumption and prostate cancer risk is inconclusive, a new study by Dr. Alan Kristal and colleagues reports that daily, heavy drinking increases the risk of high-grade prostate cancer. The paper, which appears in online in the journal CANCER, also reports that such drinking renders preventive drug therapy with finasteride ineffective.

Kristal, a nutritional epidemiologist in the Hutchinson Center’s Public Health Sciences Division, and colleagues examined the associations of total alcohol, type of alcoholic beverage and drinking pattern with risks of total, low- and high-grade prostate cancer, using data from more than 10,000 men participating in the Prostate Cancer Prevention Trial (PCPT). They found participants who reported heavy alcohol consumption (more than 50 grams of alcohol per day) and regular heavy drinking (more than four drinks per day for at least five days per week) were twice as likely or more to be diagnosed with high-grade prostate cancer.

Less heavy drinking was not associated with risk. The researchers also compared drinking patterns with treatment outcome among those diagnosed with prostate cancer enrolled on this placebo-controlled trial of the drug finasteride. They found finasteride’s ability to lower prostate cancer risk was blocked in men who drank less than 50 grams of alcohol per day.

Kristal, who is also associate head of the Cancer Prevention Program, said the findings are important because few studies have combined the following:

a careful assessment of alcohol consumption,

a sample in which there were some heavy drinkers (he said that most people participating in research studies have more healthful behavior overall; heavy drinkers are rare), and

a rigorous assessment of presence or absence of prostate cancer.

"Basically, moderate drinking has no effect on prostate cancer risk, but regular heavy drinking may, Kristal said. "Men who are using finasteride for prostate cancer prevention should reduce the amount they drink to fewer than four drinks per day."

The authors of the paper, “Alcohol Consumption, Finasteride and Prostate Cancer Risk: Results from the Prostate Cancer Prevention Trial,” include Jeannette Schenk, Dr. Catherine Tangen, Phyllis Goodman, all of the PHS division; first author Dr. Zhihong Gong, formerly of PHS who is now at the University of California San Francisco; and Dr. Ian Thompson of the University of Texas Health Science Center of San Antonio.